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Flashcards in Parrot CIS 2 Deck (24)
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1

What did the First Lady have?

Some kind of hypothyroidism

2

Differential for First Lady

-Hashimotos
-multinodular goiter
-neoplasm
-thyroid adenoma
-iodine deficiency
-diet high in goitrogens

3

What labs should we order for First Lady?

-TSH, CBC, FT4, CMP, TPO, TGB abs,
-discussion about checking urine?... Can screen urine for iodine
-rads: sono at minimum

4

On a radioactive iodine screen, is cold good or back?

Cold is bad
Hot is good

5

Is RAI uptake scan useful for Hashimoto's thyroiditis?

No

6

What complication can come from a thyroidectomy?

Don't bag the recurrent laryngeal nerve!

7

Second case: lady that lives alone, seems like she's a little high strung.... Differential?

-Graves disease
-toxic multinodular goiter
-thyroiditis
-stress
-pheochromocytoma
-afib
-toxic follicular adenoma

8

The lady also had pretibial myxedema and proptosis and a lot of things having to do with hyperthyroidism.... What stays on our differential dx?

-pheochromocytoma (prob can exclude based on vitals)
-can't really rule out a lot of the heart or thyroid things because we don't have a TSH or EKG

9

What labs should we get?

-TSH
-serum metanephrines
-FT4
-TSI
-ultrasound
-EKG

10

Normal range for Ft4?

0.8-2.2

11

Normal range for TSH

0.4-4.0

12

Normal for TSI

Not present

13

What will Graves' disease look like on ultrasound

Diffusely enlarged

14

Case 3, 45 y/o Native American male.... He had a tender to palpation thyroid nodule and had a bad viral cold for a couple of weeks... DDx?

-dequervains
-remember that this is transient and we don't really do anything for it

15

Labs for this guy?

-CRP would be high
-

16

What do we do with someone if they get a thyroidectomy

They get to stay in the hospital for a night

17

If someone has hypocalcemia from a complete thyroidectomy, what will that look like

-chvostek sign
-trousseau's sign
-hypocalcemic tetany

18

What labs would be elevated in someone who had a complete thyroidectomy?

-Phosphate
-....look in book for the rest of these... Know what will be high, normal, and low

19

If we have someone with hyperparathyroidism and kidney stones, what labs will be high and low?

-Ca2+ would be high
-PTH would be high
-low P
-high Vit D

20

67 y/o female with a fractured hip... Slipped on wet kitchen floor... Small in stature and very thin (think osteoporosis)... What will she probably have to have in the near future?

-DXA scan! That's the work up for osteoporosis

21

What score are we looking for in DXA scans?

T-scores!

22

What is the significant value for the T score

-2.5!
-if less than this, then it is osteoporosis
-if a fracture is also involved, then it's severe osteoporosis
- I think between -1.5 and -2.5 is osteopenia

23

What is the treatment for osteoporosis?

-bisphosphanates
-MUST be taken on empty stomach 30 minutes before a meal
-you have to be upright as well.... Because it affects your esophageal mucosa

24

What if she just gently bumped her hip on a car door and it broke? What disease?

-Paget's disease of the bone vs. osteomalacia